Introduction Our unit, in common with many, is increasingly using greater occipital nerve injections (GONI) in the management of headache. We therefore audited outcome in this group of patients.

Methods Patients were offered GONI as part of their headache care. The data collection period was between October 2006 and November 2008. Patients reported on duration, efficacy and satisfaction with the procedure.

Results It was possible to obtain follow-up data on 70 of 100 patients. The primary headache diagnoses were migraine without aura (MOA) 37 patients, migraine with Aura (MA) 10 patients, neuralgic forms of headache 16, trigeminal cephalgic headache (TAC) 6, and nummular headache (NH) 1. Median follow-up was 332 days. 49 of 70 (70%) patients experienced either complete or partial resolution of their headaches. Complete resolution of headache was achieved in 11/70 (15%) patients for 90 days or more, and in 9/70 (13%) patients for 180 days or more. The effect of the injection was judged “worthwhile” by 41/70 (59%) patients and side effects were considered “mild”. No statistical difference in response rate was noted between patients with analgesic overuse and those without.

Conclusion GONIs appear an effective and acceptable treatment in patients with primary headache syndromes.